Provider Demographics
NPI:1457483489
Name:POOLE, LAUREN E (NP MSN)
Entity Type:Individual
Prefix:MS
First Name:LAUREN
Middle Name:E
Last Name:POOLE
Suffix:
Gender:F
Credentials:NP MSN
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Mailing Address - Street 1:995 POTRERO AVE BLDG 80
Mailing Address - Street 2:POSITIVE HEALTH PROGRAM
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110-2859
Mailing Address - Country:US
Mailing Address - Phone:415-476-9296
Mailing Address - Fax:415-476-6736
Practice Address - Street 1:995 POTRERO AVE BLDG 80
Practice Address - Street 2:POSITIVE HEALTH PROGRAM
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-2859
Practice Address - Country:US
Practice Address - Phone:415-476-9296
Practice Address - Fax:415-476-6736
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2012-01-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CARN372415163WP2201X
CANP756363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
034678OtherSFGH INTERNAL USE ONLY-COMMERCIAL NUMBER
Q44205Medicare UPIN